In recent years, minimally invasive surgical techniques have emerged as an alternative to conventional surgical techniques to perform a plurality of surgical procedures. Minimally invasive procedures differ from conventional surgical procedures in that a plurality of devices may be introduced into the body through a small incision. As a result, trauma to the body is greatly reduced, thereby decreasing the recovery time of the patient.
One example of a common minimally invasive surgery involves laparoscopic surgical procedures. Laparoscopic procedures may be used to treat hernias, colon dysfunctions, gastroesophageal reflux disease, and gallbladder disorders. Typically, the patient undergoing the procedures will return home hours after undergoing surgery.
Generally, laparoscopic procedures require making at least one small incision in the patient's abdomen near the area of interest. A cannula or trocar may be inserted into to the incision to limit blood loss and reduce the likelihood of infection. Thereafter, various surgical instruments are introduced into the patient's body through the incision. Generally, these instruments enable the surgeon to visualize the inside of the patient's body and access the internal organs of the patient. Current laparoscopic surgical instruments include cameras, scissors, dissectors, graspers and retractors. Generally, these instruments include a handle attached to an elongated body having a distal tip used to execute the particular procedure. The handle, which remains outside the patient's body, is used by the surgeon to control the operation of the instrument during the procedure.
One challenge presented when performing minimally invasive surgical procedures relates to closing an incision made within the patient's body by a cutting laparoscopic instrument. As opposed to conventional surgical procedures, the surgeon's access to the site of the incision is greatly reduced during minimally invasive procedures. As a result, several knot pushing devices capable of advancing suture knots formed outside the patient's body to an area of interest in vivo have been developed. Typically, a suturing laparoscopy device is inserted into the patient's body and advanced to the incised area. A needle is advanced through the various tissue portions proximate the incision, thereby securing the suture material to the tissue. Thereafter, the suturing device is removed from the patient's abdomen leaving the suture material attached to the tissue. A knot is formed in the suture material and advanced along the suture material by the knot pusher to the incision, thereby applying the suture knot. The extraneous suture material is trimmed with laparoscopic scissors once the incision is adequately sutured. Occasionally, the suture knot becomes entangled in the suture material during the advancement process. The surgeon is then required to remove the entangled suture material from the incision area and reattach new suture material, thereby increasing the likelihood of infection and the patient's exposure to anesthesia.
Recently, the use of tissue sealants and other biological adhesive materials has emerged as an alternate technique of closing incisions. Preferred tissue sealants include fibrin, which is comprised of thrombin and a fibrinogen material, although other multiple component materials are available. Typically, the individual components of the adhesive material are stored in isolated reservoirs. When mixed, these components may coagulate very quickly, yielding an adhesive gel within perhaps 10 or 20 seconds. When applied to the exterior of the body, or when considerable access to the application site is possible, the rapid coagulative properties of the tissue sealant are welcomed. Though desirable for use during minimally invasive procedures, such fast-acting properties of conventional tissue sealants and adhesive have presented potential problems of fouling or clogging during the application of tissue sealants through laparoscopic devices, which typically results in the destruction of the device.
Thus, there is a need for a device capable of effectively delivering a multiple component tissue sealant to a location in vivo through from a remote location.